Lower systolic blood pressure reduces risk of stroke

http://www.eurekalert.org/pub_releases/2015-02/aha-lsb020415.php

Public Release: 11-Feb-2015
Lower systolic blood pressure reduces risk of stroke
American Stroke Association Meeting Report Abstract 79
American Heart Association

People 60 or older, especially minorities and women, have a lower risk of stroke if the top number (systolic) in their blood pressure is below 140 millimeters of mercury (mm Hg), according to a study presented at the American Stroke Association's International Stroke Conference 2015.

A report published in JAMA in 2014, advised doctors to aim for blood pressure readings of less than 150/90 mm Hg when treating patients 60 or older who do not have diabetes or chronic kidney disease. That raised the standard for systolic blood pressure, by 10 points from previous guidance, stirring controversy among healthcare providers, agencies and professional groups.

While the 2014 report relied on evidence from clinical trials, it did not consider data from various other types of studies that support a systolic blood pressure goal for these patients of less than 140, said Chuanhui Dong, Ph.D., lead author of the new study and research associate professor at the University of Miami Miller School of Medicine.

The new study, by researchers at Miami and Columbia University, involved 1,706 people older than 60 (average age 72) in the Northern Manhattan Study in New York City. None of the participants had a previous stroke, diabetes or kidney disease. After adjustment for age, sex, race/ethnicity and use of blood pressure medications, stroke risk was 70 percent higher for people with systolic pressure in the 140-149 range, compared with those whose readings fell below 140.

The results support what some health experts had feared, Dong said: "Raising the treatment bar could lead to more strokes."

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